Infectious costochondritis
Introduction
Introduction to infectious costal cartilage Infectious costal cartilage inflammation, also known as suppurative costal cartilage inflammation, is a rare surgical infection, divided into two primary and secondary, the literature reported secondary majority. Most of the primary infections are blood-borne infections. Most of the infected bacteria are Mycobacterium tuberculosis, Salmonella typhi, Paratyphoid bacillus, Pseudomonas aeruginosa, Staphylococcus, Streptococcus, Escherichia coli, Pneumococcus, etc., while secondary is more common in the chest. Infectious complications that occur after surgery. Failure to get timely and correct treatment often leads to prolonged, worsening and disabling. basic knowledge The proportion of sickness: 0.01% Susceptible people: no specific population Mode of infection: non-infectious Complications: pneumonia abscess
Cause
Causes of infectious costal cartilage
Pathogenic bacteria infection (30%):
Infectious costal cartilage inflammation is caused by infection of the cartilage of the costal cartilage and is associated with insensitivity to antibiotics. Due to the anatomical features, the 1st to 4th costal cartilage alone exists, and generally does not spread to the adjacent costal cartilage after the infection occurs. The 5th to 10th costal cartilage is connected to each other by the adjacent cartilage, and is connected to the contralateral side by the sternum xiphoid process. Inflammation can spread to each other after infection, causing multiple cartilage cartilage on the same side, and can spread to the opposite side through the xiphoid process, so that the infection range is expanded.
Iatrogenic factors (7%):
There are pus and granulation tissue around the infected costal cartilage. The surface of the ischemic necrosis of the costal cartilage is not smooth, and it changes like worm-like. Some of them become thinner and some are completely absorbed. Infectious costal cartilage inflammation is mostly secondary, and it is more common to have costal cartilage inflammation caused by infection after chest surgery. Its pathogenic bacteria are mainly purulent bacteria. This requires emphasizing prevention and strict aseptic operation to minimize or reduce damage to the costal cartilage membrane to reduce its occurrence.
Prevention
Infectious costal cartilage prevention
The disease should actively prevent suppurative bacteria and fungal infections, and active treatment should be taken after infection. Since infectious costal cartilage inflammation is mostly secondary, the costal cartilage inflammation caused by infection after chest surgery is more common, and its pathogenesis The main bacteria are purulent bacteria. It is necessary to emphasize prevention and strict aseptic operation to avoid or reduce damage to the costal cartilage membrane to reduce its occurrence.
Complication
Infectious costal cartilage complications Complications pneumonia abscess
There are mainly the following complications regarding the complications of this disease:
1. Pulmonary complications are common complications after surgery. Especially in general anesthesia, the respiratory secretions are more. After the patient wakes up, the cough reflex has not fully recovered. I can't effectively exclude respiratory secretions, which can lead to lungs such as aspiration pneumonia. Complications, therefore, for those who have more cough and weakness, should use sterile suction tube in time to remove secretions from the mouth and airway to prevent the occurrence of pulmonary complications.
2, because the patient does not dare to take a deep breath due to chest pain, cough, easy to cause lung infection, soft tissue necrosis can form abscess, abscess can form a sinus, often have obvious symptoms of systemic infection, the disease is easy to relapse, the reason for recurrence is Underestimation of the scope of the disease and inappropriate resection, therefore, the scope of surgical resection is the key to preventing recurrence.
Symptom
Infectious costal cartilage symptoms common symptoms chest pain abscess soft tissue swelling heart tingling bone destruction second rib cartilage pain
After the infection occurs, local skin will appear red, swollen, hot, painful, mainly chest pain, mostly starting from this, varying degrees of severity, patients do not dare to breathe deeply because of chest pain, cough, easy to cause lung infection, soft tissue necrosis can form abscess The abscess can form a sinus and often has obvious symptoms of systemic infection.
Examine
Infectious costal cartilage examination
X-ray and CT examinations help diagnose the disease:
1, chest X-ray film: can show local soft tissue swelling and bone destruction, can also rule out localized empyema, X-ray iodized oil sinus angiography can also show the extent of the lesion.
2, CT examination: CT examination found that the soft tissue swelling of the lesion, the destruction of costal cartilage and submucosal effusion, subperiosteal empyema can be diagnosed.
Diagnosis
Diagnosis and diagnosis of infectious costal cartilage
diagnosis
Mainly based on medical history and clinical manifestations, chest X-ray and CT examination can show local soft tissue swelling and bone destruction, chest X-ray film can exclude localized empyema, X-ray iodized oil sinus angiography can show the extent of the lesion, and Helps identify related diseases.
Differential diagnosis
The disease needs to be differentiated from chest wall tuberculosis:
1 chest wall tuberculosis generally has a history of tuberculosis or old tuberculosis, and the course of disease is relatively long;
2 The whole body does not have fever, and the blood picture does not rise;
3 local no severe pain, tenderness or slight tenderness;
4 local swelling or abscess is obvious, but the skin has no red heat;
5 puncture puncture can extract cheese samples.
